Why am I choking on my food?

As a Speech-Language Pathologist, one of the questions I am often asked is, “Why am I choking on my food?” The answer to this question is not clear-cut. In fact, there are a number of reasons why this unpleasant event might occur.

First-off, some anatomy

  1. Esophagus: the “food tube” that takes the food from your mouth to your gut
  2. Trachea: the “airway” tube that takes air from your mouth to your lungs
  3. Bolus: the food in your mouth that is mixed with your saliva and needs to be swallowed

Common culprits leading to choking

1. Did you put that in your mouth?

Most everyone knows that you need to cut round foods like carrots, grapes and hot dogs into appropriately sized pieces before feeding them to young children. Why? These foods can potentially block their small airways as they are the same size.  
Foods can also block off your airway. Food pieces that are especially large, slippery, particulate, dry or hard can pose problems for many people. Rice and corn are little culprits that you may not realize can be troublesome to swallow. Grilled calamari can be problematic for it’s slipperiness.  Dry or chewy meats can also pose a serious risk. Putting too much food into your mouth at once can also lead to choking.

2. Did you even chew that?

Before we swallow our food, we typically chew it. Think of how, when we are babies, we are given first liquids and then smooth purees to swallow until we are mature enough to chew.
Chewing is the process of breaking food down into smaller pieces and mixing it with saliva (the digestion process actually begins with our chewing as your saliva contains digestive enzymes). If food is not chewed properly, it can go down toward the food tube in chunks rather than as one cohesive unit. This can lead to bits breaking off from the main unit and travelling down the wrong pipe (the airway rather than the food tube) – causing choking.
Improper chewing can occur for many reasons. Sometimes chewing difficulties are due to a medical cause, but sometimes it can be due to not paying attention, or talking with your mouth full.

3. Boy, is it dry in here?!

Dry mouth can contribute to choking. Bits of food can get stuck on dry surfaces inside your mouth and throat and pose a choking risk when they “fall off” the surfaces they are stuck to later on. Proper lubrication is essential to all your body systems and many factors can influence the hydration status of your body. Many medications carry with them the side-effect of dry mouth. Ensure you discuss your dry mouth with your doctor and/or pharmacist to ensure that you are able to continue to enjoy meals free of choking. Click here to read more on dry mouth.

4. Some things just don’t mix, you know? 

You’ve all heard the old adage that “oil and water don’t mix”, but have you ever heard that about solids and liquids? Probably not… but some individuals have difficulty with control of different textures in their mouths (“mixed textures”). In these cases, the individual may be unable to contain the liquid part of the food in their mouth while chewing the solid part (e.g. the broth in the chicken soup). When this happens, the individual may choke on the liquid prior to beginning to swallow the other part of their mouthful.
The four choking risks described may seem simple, and to most of us, they happen rarely. If you find yourself choking more often than you used to, a visit to a Speech-Language Pathologist like me would be a good idea. There are a multitude of reasons that you may experience these problems and we will be able to help you sort through the causes and find the right treatment for your situation.

Bobi Tychynski Shimoda is a Speech-Language Pathologist with more than a decade of experience working with neurological communication and swallowing disorders. She has worked in a variety of settings including inpatient rehab, acute care, community, and private practise. She is highly skilled in assessment, and innovative treatment approaches.